Inside the MSF unit that tests new tools for the field

A Médecins Sans Frontières team trains displaced families on water filtration in Sudan. The displacement unit is currently testing filtration methods to provide for use in their homes. Photo by: MSF

BANGKOK — Médecins Sans Frontières’ four-member “displacement unit” is busy testing a new water filtration kit to provide safer drinking water options to vulnerable people fleeing violence or war. It's among the medical humanitarian’s organization’s smallest teams — but it’s been tasked with the big job of facilitating innovation for MSF missions around the world.

Established in 2015, the Nairobi-based team tests, adapts, and develops solutions to help MSF field workers better meet the needs of people on the move in crisis situations. The unit has the ability to deliver products such as temporary health structures or alternative cooking solutions during the first weeks of an emergency — with the goal of continuously monitoring and improving innovative responses in protracted humanitarian crises.

“We’re young in all senses, full of young people with very contrasting backgrounds, which makes us very agile,” said Ana Santos, who heads up the unit and describes the atmosphere of her team as “a balloon of oxygen.”

The four full-time staff members have backgrounds in industrial design, project management, logistics, and have plenty of fieldwork experience. Santos herself worked in medical device design and previously researched the use of medical equipment in humanitarian disaster response.

On any given day, more than 30,000 MSF doctors, midwives, or psychologists can be found providing assistance to people in crisis in more than 70 countries. But the displacement unit’s work isn’t overwhelming, Santos told Devex, because their job is not to talk amongst themselves and brainstorm new ideas to reach vulnerable migrants in Mexico or design better health structures for refugees in Bangladesh — both of which they’ve done. Instead, these ideas are born from requests by colleagues on the ground, and the unit then partners with outside organizations or contracts with technical experts as needed.

Unlike some units at MSF that might work as a support function, the displacement unit sits within the department of operations, which allows them close and continuous access to the field: “Our job is to act as facilitators, to help our colleagues in the field reach a little bit beyond what they might normally be exposed to — beyond ideation,” Santos said.

The MSF mission in South Sudan, for example — where millions of people have been on the run from violence since civil war broke out in December 2013 — shared that fleeing populations often lose access to basic medical care for weeks at a time. The displacement unit helped them devise a "runaway bag," a sturdy backpack filled with medical supplies like antibiotics, painkillers, anti-malaria medicine, and water purification tabs. MSF national staff who choose to flee and stay with their community can grab the pack when they go.

Other solutions are perhaps less obvious ways for the organization to address a larger health problem — and require the displacement unit to bring in outside expertise to assist in the design process.

In Nigeria, where conflict between armed groups has displaced nearly 2 million people, MSF provides medical care in displaced people’s camps in the country’s northeast Borno state. The task of venturing past the camp’s security perimeter to collect firewood often falls to women and children — who make up 79 percent of the internally displaced people in the country. As a result, MSF treats a large number of patients who have been raped, sexually assaulted, or otherwise attacked on these outings, Santos explained.

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“So we start thinking: How can you reduce the exposure of these people to this violence? What we do is really look at solutions that have been used to address this kind of problem before.”

Their work is not necessarily about inventing something entirely new, Santos stressed, but rather drawing on field experience to come up with the most suitable solution, whether it already exists in some form or not.

In this case, her unit organized discussions with displaced people and local artisans in the area to come up with a plan to make and use fuel-efficient biomass briquettes. They brought in a Kenyan expert on this technology to help them build a portable biomass press machine that people in the camps can easily use to transform biomaterials into briquettes of biochar, a long-burning firewood alternative.

The unit has since helped facilitate training for 600 households in the making and using of the briquettes, and is pleased with the results so far, Santos said. The feedback from the focus groups is positive, and field coordinators have observed that even families that haven’t yet been trained are creating their own tools to adopt the process and make their own fuel.

Another of Santos’ goals is to ensure that MSF teams in different regions are aware of innovations that may be useful in their contexts, and enabled to adopt them. The team has already prepared an information package on briquettes for any missions who also identify firewood collection as a challenge among the refugee, migrant, and IDP communities they serve. The Tanzania mission, for example, has now worked the use of briquettes into their annual budget, she said.

Right now, the displacement unit is continuing to test technology for a water filtration kit to distribute to vulnerable people enrolled in their health programs, which would allow them to recover faster and stay healthier at home — and in turn help MSF stretch their resources farther.

“Our work is mostly about promoting a way of thinking and in facilitating that those things happen,” Santos said. “We don't want to be creators, we want to be facilitators of that innovation. The true innovators are often our field teams, often the communities.”

About the author

Kelli Rogers is a global development reporter for Devex. Based in Bangkok, she covers disaster and crisis response, innovation, women’s rights, and development trends throughout Asia. Prior to her current post, she covered leadership, careers, and the USAID implementer community from Washington, D.C. Previously, she reported on social and environmental issues from Nairobi, Kenya. Kelli holds a bachelor’s degree in journalism from the University of Missouri, and has since reported from more than 20 countries.

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